How Singapore Sells Co-Payment

In Singapore, the government almost never hands out goodies free of charge. There's almost always a co-payment, even for health care and education. Western economists justify these charges as a partial remedy for "moral hazard."

But perhaps Singapore has been more successful in selling the idea because it's got better marketing. They don't defend co-payments as a way to avoid moral hazard. They defend co-payments as a way to avoid a "buffet mentality."

Many years ago I was with a university continuing education program that offered free admission to graduate students. The no-show rate for these "free registrations" was almost 100%. So I implemented a $5 charge, and the student registration rate dropped by about 75% but almost all graduate students who paid $5 for registration (rather than the regular $195 rate) showed up.

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